Co-trimazole
(Trimethoprim/Sulfamethoxazole [TMP/SMX])
(Bactrim, Septra) |
Category:
Description:
Indications:
-
Urinary
tract infections (pyelonephritis, cystitis) (E.
coli, Klebsiella and Enterobacter species, M.
morganii, P. mirabilis, P. vulgaris)
-
Shigella enteritis (S.
flexneri, S. sonnei)
-
Pneumocystis carinii pneuomonia
-
Acute
otitis media (children) (H.
influenzae, S. pneumoniae)
-
Acute
exacerbations of chronic bronchitis (adults) (H.
influenzae, S. pneumoniae)
-
Traveler’s
diarrhea (E. coli)
-
Acute
and chronic pancreatitis
-
Unlabeled
uses:
-
Cholera
-
Salmonella-type
infections
-
Nocardiosis
Contraindications:
-
Hypersensitivity
to sulfa-related medications (sulfonylureas, thiazide and loop
diuretics, carbonic anhydrase inhibitors, sunscreens with PABA, local
anesthetics)
-
Pregnancy
at term
-
Lactation
-
Infants
less than 2 months old (except congenital toxoplasmosis as adjunct
with pyrimethamine)
-
Megaloblastic
anemia caused by folate deficiency
Precautions:
-
Pregnancy
category C
-
Sulfonamides
have been associated with severe hypersensitivity reactions and death.
-
Serious
blood disorders (agranulocytosis, hepatocellular necrosis, aplastic
anemia) have been associated with sulfonamides. Perform complete blood counts. Symptoms of sore throat, fever, pallor, purpura or jaundice may
be early signs of serious blood disorders.
-
Use
with caution in patients with severe asthma or allergies.
-
Hemolytic
anemia may occur in patients with G-6-PD deficiency.
-
Photosensitization
may occur, caution patients to use protective measures against
ultraviolet or sunlight until tolerance is determined.
-
Sulfonamides
increase the effect of oral anticoagulants (warfarin).
-
Take
with a full glass of water and increase fluid intake to 2-3 liters per
day.
-
Complete
full course of therapy.
-
Parenteral
therapy may cause extravascular infiltration and local irritation.
-
For
oral suspension; store at room temperature, shake well before using
Adverse
Reactions (Side Effects):
-
Headache,
peripheral neuropathy, depression
-
Tinnitis,
vertigo
-
Nausea,
emesis, abdominal pain, anorexia, diarrhea
-
Hepatitis,
pancreatitis, stomatitis
-
Urticaria,
Stevens-Johnson type erythema multiforme
-
Crystalluria,
elevated creatinine
-
Drug
fever, chills
-
Photosensitivity
|
Dosage:
Administered
orally (tablets and suspension) and IV injection
-
Urinary
tract infections, shigellosis, acute otitis media:
-
Traveler’s
diarrhea:
-
Acute
exacerbations of chronic bronchitis
-
Pneumocystis carinii pneumonia:
-
Parenteral:
-
Prophylaxis:
-
Adults:
160mg TMPO and 800mg SMX given orally q24h
-
Children
> 2 months: 150mg/m2 TMP and 750mg/m2 SMX
given orally in equally divided doses twice a day on three
consecutive days of the week (do not exceed 320mg TMP and 1600mg
SMX per day)
|
|
|
|
The information contained here is an
abbreviated summary. For more detailed and complete information, consult the
manufacturer's product information sheets or standard textbooks
Source: Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
This information is provided by The Brookside Associates. The Brookside
Associates, LLC. is a private organization, not affiliated with any governmental
agency. The opinions presented here are those of the author and do not
necessarily represent the opinions of the Brookside Associates or the Department
of Defense. The presence of any advertising on these pages does not constitute
an endorsement of that product or service by either the US Department of Defense
or the Brookside Associates. All material presented here is unclassified.
C. 2009, 2014, All Rights Reserved
|
|